He spoke only to confirm his name, address, date of birth and that he understood the charge he faces during the three minute hearing.

Matthews is accused of the murder of Ms Wall on July 9 at the hospital, which is run by the 2gether NHS Foundation Trust.

The court heard that as the charge was so serious, the case and any bail application could only be dealt with at the Crown Court.

Emma Davies, representing Matthews, did not make any representations on her client's behalf.

No formal plea was entered and Matthews, who was wearing black t-shirt, was remanded in custody to appear at Gloucester Crown Court before Mr Justice Teare on July 15.

Peter Martin, chairman of the bench, told him: "Mr Matthews, you have heard what has been said. You are being sent for trial at the Crown Court sitting on July 15.

"You should be there for 9.30am. Do you understand."

Matthews replied: "Yes."

Yesterday Ms Wall's grieving family paid tribute to the 53-year-old victim from the Tuffley area of the city as "nothing less than one in a million".

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In a statement, her family said: "We would like to thank everyone for their support and such kind words that have been said about Sharon.

"She was nothing less than one in a million and to say that she will be missed is an understatement.

"We would ask for people to respect our privacy and allow us to grieve for her at this difficult time."

Police were continuing to investigate the incident and appealed for anyone with information to contact detectives.

Shaun Clee, chief executive of 2gether NHS Foundation Trust, said: "We are all deeply shocked by the tragic incident that occurred on one of our inpatient wards.

"The extremely sad event, which resulted in the death of a highly compassionate and dedicated colleague, has had a profound impact on everyone working in our trust.

"Sharon Wall was a well-respected healthcare assistant and everyone who knew her speaks about her warmth, caring nature and good sense of humour.

"She will be deeply missed by colleagues and the service users she supported.

"We are still in the early stages of the investigation and continue to assist Gloucestershire Police in their work.

"Above all, our thoughts remain with Sharon's friends and family. On behalf of colleagues across our trust, I extend our most sincere and deepest sympathies."

Workers at Gloucestershire Royal Hospital, on the same site as Wotton Lawn, spoke of their "shock" at the incident.

Denise Luckman, 44, an admin assistant at the endoscopy unit, said: "I've worked here for 10 years and nothing like this has ever happened.

"It has been a huge shock to everybody. You don't expect to go to work, to care for patients, and to have that happen.

"It has affected the hospital all the way through. It is on our own doorstep, it has come as a complete shock."

Mrs Luckman said staff across the hospital often worked in different units to help short-staffed wards, including Wotton Lawn.

"All the staff are very subdued," she added. "It just shows that these things can happen."

People have paid tribute to Ms Wall on social media. Tania Daniels wrote on Facebook: "I'm in shock. My thoughts are with your family. RIP lovely lady. I'll remember the times you came to my house years ago we had some good laughs and chinwags."

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